RCOC Excess Property Request Form

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Requestor Information

Name*

Company (if applicable)

Address*

City/State/Zip*

Phone*

Email*

Are you the sole abutting owner?*

Yes

No

Is the property landlocked?*

Yes

No

Have you made a previous request for this property?*

Yes

No

If yes, when?

Have you previously spoken with someone at RCOC?*

Yes

No

If yes, who?

Request Property Information

Type of Release*

Sale

Exchange

Easement

Relinquishment of Easement

Break in Limited Access

Property ID NO.*

County*

Township/City*

Address*

Nearest Cross Road*

Location*

Detailed Explanation of Request*

Electronic Signature Agreement*

By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.